kelainan gingiva
TRANSCRIPT
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KELAINAN GINGIVA
Gingivitis Gingivitis Kronis Gingivitis Modifikasi Sistemik Acute Necrotizing Ulcerative Ging.sto. Acute Primary Herpetic Ging.sto. Noma Gingival enlargement
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Gingivitis
Definisi : Inflamasi pada gingiva (>>)
Etiologi : Invasi mic.org. & produc pd plak.
Karakteristik :
1. Primer : Hanya inflamasi yg terjadi
eg. /gingivitis kronis.
2. Sekunder : Inflamasi mrp fkt sekunder dari
peny. Sistemik yg sdh ada.
Eg. Pada psn Diabetes.
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gingivitis
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Gejala klinis :1. Tipe rx infl.
A. Akut : cpt., berat, pdk.
B. Kronis : ttp, lambat, >>.
2. Perluasan rx infl.
A. Lokal : 1/ group.
B. General : menyeluruh.
3. Distribusi rx infl.
A. Papillary
B. Marginal
C. Difuse : + attached.
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Gingivitis Kronis
• Definisi : Peny. Pd gingiva kr proses infl. Kr.• Gjl klin.:
Warna : kemerahan, mrh biru/ mrh tua.
Contur : itd. Papil+mg. Udem.
Texture : stippling berkurang.
Consistensi : halus,udem - firm.
Tendensi prdrhn : > instr. & sikat gigi.
Tidak Sakit.
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Etiologi : akumulasi dan maturasi bacterial plaque pada gigi (fkt. Initiating.)
Fktr predisposisi : Kalkulus. Tamb. Overhang. Food impactie. Erupsi gigi.
Terapi : Eliminasi faktor lokal.
(Scaling, root planing, grinding).
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Faktor predisposisi
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GINGIVITIS MODIFIKASI SISTEMIK
• Definisi : kombinasi fktr iritasi lokal dan sistemik.
• Contoh:Gingivitis pada def. Vit. C.Gingivitis pada Leukemi.Gingivitis pada masa pubertas.Gingivitis pada masa kehamilan
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GINGIVITIS PADA MASA KEHAMILAN
• Definisi : Infl. Pada gingiva selama kehamilan (Pregnancy gingivitis).
• Gejala Klinis :
Warna : merah terang/kebiruan.
Kontur : itd ppl. Udem, mg : membulat.
Konsistensi : edematus / halus.
Tendensi perdrh : > pd instr.
Pregn. tumor : itd ppl. Udem (>> lokal), bukan tumor, merah tua, halus, mengkilat.
• Etiologi : Bacterial plaque, meningkatnya hormon progesteron.
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Terapi :
Eliminasi semua faktor iritasi lokal dan penyebabnya.
Scaling dan curettage.
Excisi pregnancy tumor.
Plaque control :
Teknik menyikat gigi.
Flossing.
Interdental stimulation.
Frequent recall visits.
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FLOSSING&BRUSHING
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AKUT NECROTIZING ULCERATIVE GINGIVOSTOMATITIS/ ANUG
• Definisi : inf. Akut pada gingiva (itd ppl. – jar gingi. lain secara cpt.)
• Etiologi :
Borrelia vincentii.
Fusiform baccilus.
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Gejala Klinis:
• Intra Oral :• Crater ulceration/ interdental crater.• Perdarahan kecil spontan.• Necrose jaringan gusi.• Bau mulut.• Warna gusi kemerahan, udem.• Sakit susah makan• Gigi agak goyang.• Hipersalivasi.• Lidah kecap metalik.
• Ekstra Oral / KU :• demam, malaise, pusing, anorexia, limfadenitis.
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Faktor predisposisi :
• 1. Lokal :
OH buruk.
Kalkulus.
Impacted food.
Periodontal pocket.
Tambalan overhang.
2. Sistemik :
Malnutrisi.
Kelainan/ peny. Darah.
Stress.
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Diagnosa :
Pertumbuhan cepat.
Sakit.
Ulserasi pd mg & itd ppl.
Kecap metalik.
Diff. Diagnosa :
Stomatitis herpes.
Eritema multiformis.
Difteri.
DM tdk terkontrol.
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Terapi :
• 1. Kontrol bakteri ( painful).– Pemberian Antibiotik, Analgetik, Vitamin (BC + C)
• 2. Eliminasi fkt. Predisposing lokal & sistemik.– Scaling stl gjl akut hilang.
• 3. Patient education :– Cara pemeliharaan OH.
– Periodic recall.
Penting :
Ext. gigi & Curettage KI.
Terapi 2 & 3 plg penting
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ACUTE PRIMARY HERPETIC GINGIVOSTOMATITIS
• Definisi : Suatu inf. Virus yg terjadi pd membran mukosa mulut.
• Etiologi : Virus Herpes Simplek.
• Biasa menyerang bayi dan anak /dewasa <
• Sering keliru dengan Anug.
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Gejala Klinis :
Sudden onset ( selama 7 – 10 hari ).Sakit (tdp vesikel dlm rongga mulut, pecah tjd ulserasi.Dpt mengenai gusi.Meluas ke seluruh rongga mulut.Hipersalivasi.Limfadenitis.Malaise .Demam.
Terapi : Supportif (bed rest, diet lunak).Simtomatis.
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NOMA
• Definisi : suatu gang. Dr jar. Mucocutan orifis (lip, hidung,sal. telinga luar, genital) yg cpt & fatal.
• Mulai dr perm. Mucosa (mucosa mlt >)• Spi wajah (jarang) Cancrum oris/ Gangrenous
Stomatitis.• Etiologi : Fusiform baccilus.• Spirochaeta.• Patogenesis :• Lesi awal, ulserasi pd ging. & mucosa buccal (sakit) dan
meluas dg. Cepat kmd timbul Nekrose jar. Setempat hg tl di bwhnya terlihat squester& gigi goyang/ lepas. Inf. Bisa nyebar ke pipi, bibir, palatum perforasi
• lesi necrotic halitosis.
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Faktor predisposisi :
• Lokal :Patahan gigi, protesa.
OH buruk.
Trauma.
• Sistemik :Malnutrisi, bayi prematur.
Peny. Kronis (Pneunomoni)
Peny. Yg lemahkan tbh (campak)
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Gejala klinis :
Halitosis.
Gigi lepas.
Perforasi pipi dan bibir.
Hipersalivasi.
Diagnosa : adanya suatu proses perkembangan gangren yg cepat pd bayi
malnutrisi/ prematur dgn gejala sistemik ringan.
Terapi :Antibiotik dosis tinggi.
Perbaikan nutrisi.
Debridement jaringan nekrose.
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GINGIVAL ENLARGEMENT
• Definisi : suatu keadaan bertambah besarnya gusi.• 1. Hipertrofi (Inflamatory)
– Ukuran sel >>• 2. Hipereplasi (fibrotic)
– Jumlah sel >>
• Etiologi• 1. Faktor lokal
OH<<, akumulasi kalkulusMalposisi gigi.Cara sikat gigi yg salah.Gangguan oklusi.Iritasi protesa, pesawat orto.Nafas lewat mulut.
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2. Faktor Sistemik
Endokrin NutrisiKelainan darah.Obat-obatan.Idiopatik.
Klasifikasi Gingival enlargement.1. Inflamatory enlargement
- Kronis
- Akut
2. Non inflamatory hiperplastic enlargement
- obat-obatan
- Familial.
3. Kombinasi
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4. Pembesaran gingiva dg kondisi tertentu.
5. Neoplastic enlargement.
6. Perkembangan/ development enlargement.
HIPERTROFI/INFLAMATORY GINGIVADefinisiBertambahnya ukuran sel ging. Karena proses
peradangan/inflamasi (gingivitis).
Faktor penunjanga. Lokal : OH buruk,iritasi lokal, malposisi gigi,dll.
b. Sistemik : perubahan hormonal .
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Gejala Klinis
Gusi merah terang& mudah berdarah.Perm. Halus/edematous.Palpasi lunak.Interdental papil tumpul.Tdp pocket/ saku gusi.Pit on pressure.Bau mulut.
DiagnosisEdematous gingivaWarna merah terang.Tendensi perdarahan.
TerapiLokal.Sistemik.
.
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HIPERPLASI/FIBROTIC GINGIVA
• Definisi• Pembesaran gingiva karena bertambahnya sel dan jar. Ikat
pd gingiva. Jarang (sering kr obat)
• Etiologi
a. Sistemik : merupakan faktor utama.Pemberian obatPeny. Sistemik.Idiopatik.
b. Lokal :OH buruk,Iritasi lokal >> hiperplasi.
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Gejala Klinis
Warna normal/ pucat.Palpasi keras/tidak sakit.Jarang. Batas tegas.Bila terjadi pada margin gingiva, disebabkan kr Dilantin.Jika menyeluruh Difuse fibromatosa.(Terjadi perub profil/ btk muka, gang. Bicara/ makan.
TerapiPengobatan pen. Sistemik.Kontrol/ stop obat.Gingivectomy.Hilangkan fkt iritasi lokal.
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dilantin